Search Results (1,091)

Microbiome analysis has revolutionized our understanding of various biological processes, spanning human health and epidemiology (including antimicrobial resistance and horizontal gene transfer), as well as environmental and agricultural studies. At the heart of microbiome analysis lies the characterization of microbial communities through the quantification of microbial taxa and their dynamics. In the study of bacterial abundances, it is becoming more relevant to consider their relationship, to embed these data in the framework of network theory, allowing characterization of features like node relevance, pathways, and community structure. In this study, we address the primary biases encountered in reconstructing networks through correlation measures, particularly in light of the compositional nature of the data, within-sample diversity, and the presence of a high number of unobserved species. These factors can lead to inaccurate correlation estimates. To tackle these challenges, we employ simulated data to demonstrate how many of these issues can be mitigated by applying typical transformations designed for compositional data. These transformations enable the use of straightforward measures like Pearson’s correlation to correctly identify positive and negative relationships among relative abundances, especially in high-dimensional data, without having any need for further corrections. However, some challenges persist, such as addressing data sparsity, as neglecting this aspect can result in an underestimation of negative correlations. Full article

Early detection of clinical deterioration in emergency department (ED) patients is critical for timely interventions. This study evaluated the predictive performance of the National Early Warning Score (NEWS) parameters using machine learning. We conducted a single-center retrospective observational study including 27,238 adult ED patients admitted to Merano Hospital (Italy) between June 2022 and June 2023. NEWS vital signs were collected at triage, and mortality at 48 h, 7 days, and 30 days was obtained from ED database. Decision tree analysis (CHAID algorithm) was used to identify predictors of mortality; 10-fold cross-validation was applied to avoid overfitting. Mortality was 0.4% at 48 h, 1% at 7 days, and 2.45% at 30 days. For 48-h mortality, oxygen supplementation (FiO₂ >21%) and AVPU = “U” were the strongest predictors, with a maximum risk of 31.6%. For 7-day mortality, SpO₂ was the key predictor, with mortality up to 48.1%. At 30 days, patients with AVPU ≠ A, FiO₂ > 21%, and SpO₂ ≤ 94% had a mortality risk of 66.7%. Decision trees revealed different cut-offs compared to the standard NEWS. This study demonstrated that for ED patients, the NEWS may require some adjustments in both the cut-offs for vital parameters and the methods of collecting these parameters. Full article

Background: Upper-limb impairment is a major cause of post-stroke disability, limiting participation in meaningful activities. Robotic rehabilitation may address this by delivering high-dosage, task-oriented training while reducing clinician workload. However, limited clinical translation of robotic interventions may be partly due to poor reporting in the literature. This systematic review evaluated the intervention-reporting quality (completeness and consistency) of randomized controlled trials (RCTs) comparing robotic and conventional upper-limb stroke rehabilitation. Methods: Four databases were searched for RCTs investigating robotic upper-limb interventions compared with dose-matched conventional interventions for people with stroke. Intervention reporting was assessed using the TIDieR-Rehab checklist. Trained reviewers independently extracted and evaluated data, resolving discrepancies through consensus. Completeness and consistency were analyzed descriptively. Results: Among 25 RCTs, the overall reporting completeness was low (43%). Robotic interventions were better described (50%) than conventional interventions (36%). While timing and total dose were commonly reported, critical details on provider expertise, active dose, progressive challenge, personalization, and harms were often omitted. Reporting consistency was moderate (68%), with key information dispersed across article sections. Conclusions: Inadequate reporting limits the transparency, replication, and implementation of robotic upper-limb interventions. Adopting structured reporting frameworks like TIDieR-Rehab is essential for advancing the field. Full article

High-Intensity Focused Ultrasound (HIFU) is a non-invasive technology widely used in aesthetic dermatology for skin tightening and facial rejuvenation. This study aimed to evaluate the safety and efficacy of a modified HIFU device, More Young, compared to the standard 7D HIFU system through a randomized, single-blinded clinical trial. The More Young device features enhanced focal depth precision and energy delivery algorithms, including nine pre-programmed stabilization checkpoints to minimize treatment risks. A total of 100 participants with facial wrinkles and skin laxity were randomly assigned to receive either More Young or 7D HIFU treatment. Skin improvements were assessed at baseline and one to six months post-treatment using the VISIA^® Skin Analysis System (7th Generation), focusing on eight key parameters. Patient satisfaction was evaluated through the Global Aesthetic Improvement Scale (GAIS). Data were analyzed using paired and independent t-tests, with effect sizes measured via Cohen’s d. Both groups showed significant post-treatment improvements; however, the More Young group demonstrated superior outcomes in wrinkle reduction, skin tightening, and texture enhancement, along with higher satisfaction and fewer adverse effects. No significant differences were observed in five of the eight skin parameters. Limitations include the absence of a placebo group, limited sample diversity, and short follow-up duration. Further studies are needed to validate long-term outcomes and assess performance across varied demographics and skin types. Full article

Objective: This study aims to critically review and synthesize the existing literature on the use of voice analysis in assessing nasal obstruction, with a particular focus on acoustic parameters. Data sources: PubMed, Scopus, Web of Science, Ovid Medline, and Science Direct. Review methods: A comprehensive literature search was conducted without any restrictions on publication year, employing Boolean search techniques. The selection and review process of the studies followed PRISMA guidelines. The inclusion criteria comprised studies with participants aged 18 years and older who had nasal obstruction evaluated using acoustic voice analysis parameters, along with objective and/or subjective methods for assessing nasal obstruction. Results: Of the 174 abstracts identified, 118 were screened after the removal of duplicates. The full texts of 37 articles were reviewed. Only 10 studies met inclusion criteria. The majority of these studies found no significant correlations between voice parameters and nasal obstruction. Among the various acoustic parameters examined, shimmer was the most consistently affected, with statistically significant changes identified in three independent studies. A smaller number of studies reported notable findings for fundamental frequency (F0) and noise-related measures such as NHR/HNR. Conclusion: This systematic review critically evaluates existing studies on the use of voice analysis for assessing and monitoring nasal obstruction and hyponasality. The current evidence remains limited, as most investigations predominantly focus on glottic sound and dysphonia, with insufficient attention to the influence of the vocal tract, particularly the nasal cavities, on voice production. A notable gap exists in the integration of advanced analytical approaches, such as machine learning, in this field. Future research should focus on the use of advanced analytical approaches to specifically extrapolate the contribution of nasal resonance to voice thus defining the specific parameters in the voice spectrogram that can give precise information on nasal obstruction. Full article

Background: Breast and prostate cancer represent a significant global public health burden. Among the adverse effects of oncological treatments, fatigue is one of the most prevalent, persistent, and disabling symptoms. Therapeutic exercise has been shown to be effective for its management, with supervision identified as a key factor that may enhance adherence, safety, and intensity control. This systematic review and meta-analysis aimed to compare the effects of supervised exercise programs versus usual care on cancer-related fatigue in patients with breast or prostate cancer. Methods: A systematic search (September–December 2024) was conducted in six databases (PubMed, Web of Science, Scopus, Cochrane, PEDro, Scielo), selecting RCTs from the past 10 years in English or Spanish. Studies compared supervised exercise with unsupervised exercise or usual care in stage I–III breast or prostate cancer patients within five years post-treatment. Methodological quality was assessed with the PEDro scale and risk of bias with Cochrane’s RoB 2.0. A random-effects model was used to calculate pooled effect sizes (ES, 95% CI), with heterogeneity (I²), sensitivity, subgroup, and publication bias analyses. Results: A total of 25 interventions from 19 randomized controlled trials involving over 2200 participants were included. Supervised exercise significantly reduced cancer-related fatigue compared to usual care (effect size = 0.34; 95% CI: 0.22–0.47; p < 0.001; I² = 56%). Sensitivity analyses supported the robustness of the findings. Subgroup analyses revealed greater effects in combined exercise programs, in men, and in patients with prostate cancer. No evidence of publication bias was observed. While 73.7% of studies were rated as having good methodological quality, the risk of bias was often unclear or high. Conclusions: Supervised therapeutic exercise programs are effective and safe for reducing fatigue in breast and prostate cancer survivors. These interventions should be incorporated into comprehensive care plans, with individualization based on patients’ clinical and demographic characteristics. Further research is needed to identify the most effective and sustainable strategies for different patient subgroups. Full article

Anthyllis vulneraria is a traditional medicinal plant with confirmed anti-inflammatory properties, attributed to its high polyphenolic content. This study aimed to evaluate the wound-healing potential of A. vulneraria leaf extract in a rat burn model. Four groups of eight Wistar rats each received the following daily topical applications for 14 days: vehicle cream (negative control); silver sulfadiazine (positive control); or plant-based creams containing either 1 mg/cm² or 2 mg/cm² of polyphenols (experimental groups 1 and 2, respectively). On days 7 and 14, four animals per group were euthanized for histological and oxidative stress evaluations. LC-MS/MS analysis of the leaf extract identified hyperoside, ferulic acid, and p-coumaric acid as major constituents. Experimental group 1 showed significantly enhanced wound closure on days 5 and 7, while group 2 exhibited a significant effect on day 5. All oxidative stress markers, except catalase activity, differed significantly among the groups, with the most favorable results observed in group 2. IL-8 levels decreased after the extract treatment, while no significant microscopic changes were observed. These results indicate that A. vulneraria leaf extract may serve as a valuable adjuvant in burn wound healing. Full article

A novel macrodesign for a dental implant characterized by a non-monotonic variation in core diameter and thread shape has been described to produce lower stress levels during insertion as compared to conventional tapered implants. Two finite element models resembling the lower left molar region with preformed osteotomies were created based on a cone beam computed tomography (CBCT) scan. Insertion of both the novel and the conventional, tapered implant type were simulated using Standard for the Exchange of Product model data (STEP) files of both implant types. Von Mises equivalent stress, strain development, and amount of redistributed bone were recorded. The conventional implant demonstrated a continuous increase in strain values and reaction moment throughout the insertion process, with a brief decrease observed during the final stages. Stress levels in the cortical bone gradually increased, followed by a reduction when the implant was finally positioned subcrestally. The novel implant achieved the maximum magnitude of reaction moment and cortical bone strain values when the implant’s maximum core diameter passed the cortical bone layer at around 60% of the insertion process. Following a notable decrease, both the reaction moment and stress started to rise again as the implant penetrated further. The novel implant removed more bones in the trabecular region while the conventional implant predominantly interacted with cortical bone. Overall, the novel design seems to be less traumatic to alveolar bone during the insertion process and hence may lead to reduced levels of initial peri-implant bone loss. Full article

The present study aims to investigate the multi-year effects (5 years) of individualized whole-body vibration (WBV) on locomotion, postural control, and handgrip strength in a 68-year-old man with relapse remitting multiple sclerosis (PwRRMS). The dose–response relationship induced by a single session was quantified by determining the surface electromyographic activity (sEMG) of the participant. The participant wore an orthosis to limit the lack of foot dorsiflexion in the weakest limb during walking in daily life. The gait alteration during walking was assessed at 1, 2 and 3 km/h (without the orthosis) through angle–angle diagrams by quantifying the area, perimeter and shape of the loops, and the sEMG of leg muscles was recorded in both limbs. The evaluation of postural control was conducted during upright standing by quantifying the displacement of the center of pressure (CoP). The handgrip strength was assessed by measuring the force–time profile synchronized with the sEMG activity of upper arm muscles. The participant improved his ability to walk at higher speeds (2–3 km/h) without the orthosis. There were greater improvements in the area and perimeter of angle–angle diagrams for the weakest limb (Δ = 36–51%). The sEMG activity of the shank muscles increased at all speeds, particularly in the tibialis anterior of weakest limbs (Δ = 10–68%). The CoP displacement during upright standing decreased (Δ = 40–60%), whereas the handgrip strength increased (Δ = 32% average). Over the 5-year period of intervention, the individualized WBV improved locomotion, postural control and handgrip strength without side effects. Future studies should consider the possibility of implementing an individualized WBV in PwRRMS. Full article

Resistance of various bacterial pathogens to the activity of clinically approved drugs currently leads to serious infections, rapid spread of difficult-to-treat diseases, and even death. Taking the threats for human health in mind, researchers are focused on the isolation and characterization of novel natural products, including plant secondary metabolites. These molecules serve as inspiration and a suitable structural platform in the design and development of novel semi-synthetic and synthetic derivatives. All considered compounds have to be adequately evaluated in silico, in vitro, and in vivo using relevant approaches. The current review paper briefly focuses on the chemical and metabolic properties of resveratrol (1), as well as its oligomeric structures, viniferins, and viniferin-based molecules. The core scaffolds of these compounds contain so-called privileged structures, which are also present in many clinically approved drugs, indicating that those natural, properly substituted semi-synthetic, and synthetic molecules can provide a notably broad spectrum of beneficial pharmacological activities, including very impressive antimicrobial efficiency. Except for spectral verification of their structures, these compounds suffer from the determination or prediction of other structural and physicochemical characteristics. Therefore, the structure–activity relationships for specific dihydrodimeric and dimeric viniferins, their bioisosteres, and derivatives with notable efficacy in vitro, especially against chosen Gram-positive bacterial strains, are summarized. In addition, a set of descriptors related to their structural, physicochemical, pharmacokinetic, and toxicological properties is generated using various computational tools. The obtained values are compared to those of clinically approved drugs. The particular relationships between these in silico parameters are also explored. Full article

Background: Considering the critical role of physical activity (PA) beginning in early childhood education and the demonstrated validity and reliability of contemporary technological measurement tools, this paper aimed to systematically review and analyze studies comparing PA levels in preschool-aged children during weekdays versus weekend days, using objective technological devices, and highlight what factors correlate with children’s PA. Methods: The search strategy was designed based on the PICOS framework. A systematic review was conducted using two databases (PubMed and Web of Science) to identify studies that included preschool children doing PA during weekdays, measured through technological devices, and compared to PA during weekend days. Study quality was evaluated using the MINORS scale. Results: From 1959 articles, 30 documents met the inclusion criteria, encompassing 32,251 preschool children. Conclusions: The results suggest that preschoolers were generally more active on weekdays than weekends, although it could depend more on contextual or individual factors than on the day of the week. In this sense, parental/maternal behavior (sedentary behavior, shared activities during weekend days, parents’ educational level, and parental/maternal screen time) influences children’s PA level, as well as other factors such as gender, morphology, motor competence level, the type of activity (indoor vs. outdoor), age, meeting PA guidelines, and the community transportation environment. Considering these factors, professionals working in preschools or kindergartens, as well as parents/mothers, should consider these factors to foster children’s PA level from early childhood, which could influence children’s lifespan. Full article

The sustainable production of plant bioactive compounds is increasingly important as natural habitats decline. This study investigates whether in vitro cell cultures of Eryngium planum, Lychnis flos-cuculi, and Kickxia elatine can serve as alternative sources of biologically active biomass with antimicrobial and anti-Acanthamoeba properties. Callus cultures were established under optimized and controlled conditions, and metabolomic profiling was completed using UPLC-HRMS/MS. In silico analysis, using a molecular docking approach, was applied to understand the interaction between target compounds and Acanthamoeba profilin and identify possible targets for antimicrobial properties. Untargeted metabolomic analysis confirmed the presence of valuable compounds in the callus cultures of the studied species. Biological activity was assessed through anti-Acanthamoeba and antimicrobial assays. Lychnis flos-cuculi and Kickxia elatine callus extracts showed significant inhibitory effects on Acanthamoeba trophozoites, with 87.5% and 80.1% inhibition at 10 mg/mL, respectively. In contrast, E. planum extract stimulated amoebic growth. The anti-Acanthamoeba activity correlated with the presence of ferulic acid and p-coumaric acid in L. flos-cuculi extract, and acteoside in K. elatine extract. Antibacterial testing revealed moderate activity of E. planum and K. elatine extracts against Staphylococcus spp., while Gram-negative bacteria and fungi were largely resistant. These findings highlight the potential of in vitro cultures—particularly those from L. flos-cuculi and K. elatine—as promising, sustainable sources of anti-Acanthamoeba and antimicrobial agents, warranting further investigation into their pharmacologically active constituents. Full article

Huntington’s disease (HD) is a severe and progressive neurodegenerative disease for which therapeutic options have so far been confined to symptomatic treatment. Currently, the diagnosis relies on the signs and symptoms shown by patients; however, by that stage, the psychomotor issues have progressed to a point where reversal of the condition is unattainable. Although numerous clinical trials have been actively investigating therapeutic agents aimed at preventing the onset of disease or slowing down the disease progression, there has been a constant need for reliable biomarkers to assess neurodegeneration, monitor disease progression, and assess the efficacy of treatments accurately. Therefore, to discover the key biomarkers associated with the progression of HD, we employed bioinformatics and machine learning (ML) to create a robust pipeline that integrated differentially expressed gene (DEG) analysis with ML to select potential biomarkers. We performed a meta-analysis to identify DEGs using three Gene Expression Omnibus (GEO) microarray datasets from different platforms related to HD-affected brain tissue, applying both relaxed and strict criteria to identify differentially expressed genes. Subsequently, focusing only on genes identified through the inclusive threshold, we employed 19 diverse ML techniques to explore the common genes that contributed to the top three selected ML algorithms and the shared genes that had an impact on the ML algorithms and were observed in the meta-analysis using the stringent condition were selected. Additionally, a receiver operating characteristic (ROC) analysis was conducted on external datasets to validate the discriminatory power of the identified genes. Based on the results of an inverse variance weighted meta-analysis of the AUCs across both human and mouse cohorts, GABRD and PHACTR1 were identified as the most robust candidates and were selected as key biomarkers for HD. Our comprehensive methodology, which integrates DEG meta-analysis with ML techniques, enabled a systematic prioritization of these biomarkers, providing valuable insights into their biological significance and potential for further validation in clinical research. Full article

(1) Background: Human Papillomavirus (HPV)-associated oropharyngeal cancer is the fastest-growing head and neck malignancy, yet vaccination coverage remains suboptimal. (2) Methods: In this cross-sectional survey conducted from April 2022 to April 2023, 400 parents of patients aged 8–18 years (mean ± SD = 12.8 ± 2.6; 59.3% female) reported their child’s HPV vaccination status and willingness to initiate or complete the vaccine series at a dental clinic. For those who were not fully vaccinated, reasons for refusal were documented. (3) Results: Over half (54.5%, n = 218) of the children were not fully vaccinated. Notably, 21% (46/218) of parents indicated an immediate willingness to vaccinate their child if the dentist offered it—a significant potential for improvement compared to general healthcare settings. Reported barriers included preference for a physician’s office (43.6%), indecision (20.3%), unspecified concerns (14.5%), safety worries (8.1%), and religious objections (5.2%). Male and younger patients (9–11 years) showed significantly lower vaccination coverage (p < 0.05). (4) Conclusions: Dentists can substantially impact public health by integrating immunization counseling, interprofessional collaboration, and vaccine administration, thereby addressing critical gaps in HPV-related cancer prevention. These findings highlight the opportunity for dental offices to enhance vaccination rates and prompt further research, education, and policy initiatives to advance the oral and general health of our patients. Full article

It is critical to provide life-sustaining treatment to OHCA patients before ambulance care arrives. However, incorrectly performed resuscitation maneuvers reduce the chances of survival and recovery for the victims. Therefore, we must train regularly and learn how to do it correctly. To facilitate regular chest compression training, this study aims to improve the accuracy of a chest compression evaluation system using posture estimation and to develop a web application. To analyze and enhance accuracy, the YOLOv8 posture estimation was used to examine compression depth, recoil, and tempo, and its accuracy was compared to that of the manikin, which has evaluation systems. We conducted comparative experiments with different camera angles and heights to optimize the accuracy of the evaluation. The experimental results showed that an angle of 30 degrees and a height of 50 cm produced superior accuracy. For web application development, a system has been designed to allow users to upload videos for analysis and obtain appropriate compression parameters. The usability evaluation of the application confirmed its ease of use and accessibility, and positive feedback was obtained. In the conclusion, these findings suggest that optimizing recording conditions significantly improves the accuracy of posture-based chest compression evaluation. Future work will focus on enhancing real-time feedback functionality and improving the user interface of the web application. Full article